Digestive Diseases and Sciences

, Volume 57, Issue 11, pp 3004–3010

Finasteride and Methadone Use and Risk of Advanced Hepatitis C Related Liver Disease

  • Donna L. White
  • Ali Hashmi
  • David J. Ramsey
  • Jill Kuzniarek
  • Shahriar Tavakoli-Tabasi
  • Hashem B. El-Serag
Original Article

DOI: 10.1007/s10620-012-2231-3

Cite this article as:
White, D.L., Hashmi, A., Ramsey, D.J. et al. Dig Dis Sci (2012) 57: 3004. doi:10.1007/s10620-012-2231-3

Abstract

Aim

We evaluated the association between two medications that alter bioavailable androgen levels, finasteride and methadone, and risk of advanced HCV-related liver disease.

Background

Males have strikingly greater cirrhosis risk across disease etiologies, including hepatitis C virus (HCV) infection.

Methods

In a cross-sectional study in HCV+ male veterans, we determined medication use by up to 15-year medical record review, and hepatic pathology by the FibroSURE-ActiTest (F3/F4-F4, advanced vs. F0-F3, mild fibrosis; and A2/A3-A3, advanced vs. A0-A2, mild inflammation). We performed race-adjusted and race-stratified multivariate analyses.

Results

Among 571 HCV+ males, 43 % were White and 57 % African-American. There were non-significant decreased risks with finasteride use (ORadj advanced fibrosis = 0.75, 95 % CI 0.39–1.45 and ORadj advanced inflammation = 0.74, 95 % CI 0.41–1.43). For methadone, there was a non-significant 41 % increased advanced fibrosis risk in Whites and 51 % reduced risk in AA. White male methadone-users had 2.1-fold excess advanced inflammation risk (p = 0.15).

Conclusions

Our preliminary study results suggest finasteride use is not significantly associated with a decreased risk of advanced hepatic fibrosis or inflammation in HCV+ males. The ethnically-divergent results for methadone associated fibrosis risk and finding of potentially increased inflammation risk in White males suggests the need for additional research.

Keywords

HepatologyEpidemiologySex hormonesUrologyDrug addiction

Abbreviations

AA

African-American

HCV

Hepatitis C virus

Copyright information

© Springer Science+Business Media, LLC (Outside the USA) 2012

Authors and Affiliations

  • Donna L. White
    • 1
    • 2
    • 3
  • Ali Hashmi
    • 2
    • 3
  • David J. Ramsey
    • 1
  • Jill Kuzniarek
    • 1
  • Shahriar Tavakoli-Tabasi
    • 4
    • 5
  • Hashem B. El-Serag
    • 1
    • 2
    • 3
  1. 1.Clinical Epidemiology and Outcomes Program, Houston VA Health Services Research and Development Center of ExcellenceMichael E. DeBakey Veteran Affairs Medical CenterHoustonUSA
  2. 2.Section of Gastroenterology and Hepatology, Department of MedicineBaylor College of MedicineHoustonUSA
  3. 3.Section of Gastroenterology and HepatologyMichael E. DeBakey Veteran Affairs Medical CenterHoustonUSA
  4. 4.Hepatitis C Clinic, Section of Infectious DiseasesMichael E. DeBakey Veteran Affairs Medical CenterHoustonUSA
  5. 5.Section of Infectious Diseases, Department of MedicineBaylor College of MedicineHoustonUSA